A Rare Presentation of Pseudomonas Putida Bacteremia Secondary to Skin and Soft Tissue Infection.

Abstract

Pseudomonas putida is a rod-shaped, flagellated, non-lactose fermenting, gram negative bacterium, usually found in water and soil habitats. P. putida generally causes nosocomial infections in immunocompromised patients. Increased infection rates are seen in those patients with medical devices inserted, due to this organism's innate ability to attach to moist and inanimate objects. In this case report we present a 63-year-old male patient with a past medical history of type II diabetes mellitus, chronic kidney disease stage 5, and hypertension who presented with P. putida cellulitis and bacteremia. This patient had no exposure to contaminated water sources or soil; however, had immunocompromising comorbidities such as diabetes and chronic kidney disease. The patient was treated with intravenous (IV) antibiotics with vancomycin and cefepime which was de-escalated within 48 hours after obtaining sensitivity data from the blood cultures. The patient had an uneventful recovery and was discharged home in a stable condition. This case highlights the importance of considering P. putida as a potential pathogen in immunocompromised patients with no direct exposure to typical environmental sources. Prompt identification and targeted antimicrobial therapy is necessary for a favorable outcome.